Association between systemic inflammation response index and risk of major adverse cardiovascular events in adults with and without metabolic syndrome: a prospective cohort study in Shanghai, Pudong.

In contrast, among participants without MS (n = 1,880), the magnitude of the association between SIRI and MACE risk was strongest in the SIRI Q2 group, which exhibited a significant increase in MACE risk (HR = 1.83, 95% CI: 1.2-2.60, P < 0.001); the associations were gradually attenuated in the higher quartiles, with marginally significant risks observed in SIRI Q3 (HR = 1.41, 95% CI: 0.97–2.06, P = 0.073) and SIRI Q4 (HR = 1.46, 95% CI: 1.01–2.12, P = 0.043).

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Finally, the RCS analysis for non-linearity did not reach statistical significance in some subgroups, which may be due to limited statistical power. 5.

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